Motivating Boys with ADHD: The Benefits of a Token Economy

By Meghan Vivo

Teenagers are notoriously bad at following the rules, but boys with Attention Deficit Hyperactivity Disorder (ADHD) have unique struggles with managing their own behavior, even with tasks as seemingly simple as basic hygiene and getting ready for school. The very nature of ADHD makes it difficult for teens to exert self-control, pay attention, and listen to and follow instructions.

For many families, a typical day goes as follows: teen misbehaves, then parent yells, argues or gives in. But these responses, which draw attention and engage the teen in a discourse, reinforce the negative behavior and encourage more acting out.

Instead, experts at Stone Mountain School, a therapeutic boarding school for boys ages 11 to 17 with emotional, behavioral and learning issues such as ADHD, advise parents to set up a token economy similar to the one in place at the school.

How a Token Economy Works

A token economy is a reward system in which a parent or teacher creates a list of behaviors they'd like to encourage in the child, and the child is offered rewards for appropriate conduct.

"Kids with ADHD tend to get attention only when they're doing something wrong," says Leigh Uhlenkott, MS, LPC, NCC, LMHC, the clinical director at Stone Mountain School. "With a token economy, we focus our time and energy on rewarding the positives."

At Stone Mountain School, some examples of desirable behaviors include:

Brushing teeth

Putting on clean clothes

Keeping a clean and tidy personal area

Good manners during meals

Completing chores on time

Cooperation, respect and participation in the classroom

The boys receive one point for each desired behavior, and accumulated points can be used to "buy" special snacks, supervised computer time, lunch with staff, iTunes gift cards, more phone time with their parents, special approved items their parents have sent or other rewards.

Every behavior is valued at one point so students aren't able to manipulate the system by picking and choosing the rules to obey. Because the child has to want the reward in order for the system to be effective, the staff at Stone Mountain School requests feedback and suggestions from the students and tries to offer items that will motivate them.

One of the rules of the school's token economy is that students must take care of their needs before their wants. For example, lost or damaged school supplies and hygiene items must be replaced, if needed, before a student can earn a special snack or more free time. In this way, students learn the difference between needs and wants, and are encouraged to take care of their belongings.

Stone Mountain School operates on a "stage" system, where new students enter at "Sleeper" stage and progress through the "Observer," "Seeker," "Storyteller" and, finally, "Giver" stages. The token economy mirrors these stages, with Sleepers being able to buy mostly necessities and Givers being able to buy mostly wants. Students can earn up to 255 points per week, which leaves plenty of room to satisfy both their needs and wants.

The system also leaves room for mistakes. "We believe in second chances," says Uhlenkott. "The boys at Stone Mountain can have a rough day and still get some of their wants, but if they struggle all week, they'll realize they need to make some changes. Every day is a new chance to succeed."

The school prohibits sharing, trading, borrowing or lending points, and any edible rewards must be consumed that day. These rules ensure that students are truly experiencing the consequences of their own actions. In addition, the staff monitors how students spend their points to make sure the boys aren't spending all of their points on snacks or soda.

Positive Reinforcement vs. Punishment

A token economy is based on the principles of positive reinforcement. The teachers and staff at Stone Mountain School provide immediate feedback when a student behaves appropriately, offering praise for completing a task and encouraging more positive behavior. At the end of each day, the staff goes over each student's token sheet so that the boys are reminded every day of the rules and the benefits of good behavior.

Over time, the positive reinforcement of a token economy becomes generalized and the adolescent is motivated to behave appropriately without tokens. Better than punishment, which often suppresses negative behaviors temporarily without generating lasting change, erodes trust and encourages teens to get better at hiding negative behaviors, a token economy actually results in better behavior and happier families.

"Boys with ADHD don't do well with punishment – it's hard for them to remember their previous negative behaviors and correct them," explains Uhlenkott. "They do much better with positive reinforcement and immediate feedback where we're not always focusing on the negative – that's why the token economy works so well."

What Teens with ADHD Gain From a Token Economy

In addition to the benefits already described, token economies offer the following:

Self-Confidence. A token economy helps teens become more responsible and teaches them how to budget and manage their resources. These life skills build self-esteem and a sense of empowerment, both of which are critical for boys with ADHD who are sometimes accustomed to feeling like they can't do anything right.

Structure. With clear rules and consequences, a token economy provides structure and consistency, which help teens with ADHD to control impulsiveness and hyperactivity. "When the expectations are clear, you avoid power struggles while keeping the teens motivated to do what they're supposed to be doing," explains Uhlenkott.

Patience. Token economies teach young people to delay gratification – a skill that is especially important for boys with ADHD – as they earn points every day that can be traded in once a week.

Therapeutic Value. The token economy helps staff at private boarding schools for teens with ADHD to understand how each student is behaving and which areas need to be addressed in therapy.

A Taste of Adulthood. Token economies teach a way of behaving that is true to real world living. Adults go to work because they need a paycheck; we sign up for certain credit cards because they offer rewards like frequent flier miles, cash back or special merchandise. The principles of a token economy prepare teens with ADHD for adulthood.

Making Peace at Home

The response from students and parents at Stone Mountain School has been overwhelmingly positive since the school started the token economy system more than a year ago. "The parents are happier because they can focus on the positive, and the boys are happier because they feel good about themselves," notes Uhlenkott.

For many families, managing their ADHD child's behaviors can be a full-time job. Private schools for boys like Stone Mountain School specialize in helping kids with ADHD and other behavioral issues get back on track in school while learning ways to manage their behavior through therapy, behavioral management techniques, and plenty of activities and opportunities to be a kid.

Stone Mountain School also has a comprehensive family program that teaches parents more effective communication strategies and ways to implement their own token economy at home. With guidance and support from caring professionals, parents can stop saying "no" and start saying "yes" in a home environment where everybody wins.